DA10--Payment Integrity Validation and Oversight Tool (VA-26-00015670) RFI 3
Overview
Buyer
Place of Performance
NAICS
PSC
Set Aside
Original Source
Timeline
Qualification Details
Fit reasons
- NAICS alignment with historical contract wins in similar service areas.
- Scope strongly matches core technical capabilities and delivery model.
Risks
- Past performance thresholds may require one additional teaming partner.
- Potential clarification needed on staffing minimums before bid/no-bid.
Next steps
Validate eligibility requirements, assign capture owner, and schedule partner outreach to confirm teaming strategy before submission planning.
Quick Summary
The Department of Veterans Affairs (VA), Office of Information & Technology (OIT), is conducting market research through RFI 3 for a Payment Integrity Validation and Oversight Tool (PIVOT). The VA seeks a SaaS-based solution to proactively detect and prevent improper VA Community Care healthcare claims payments, including fraud, waste, and abuse (FWA). This RFI is for planning purposes only and may inform future set-aside decisions. Vendor intent to participate in demonstrations is due January 23, 2026, and full submissions are due February 6, 2026.
Purpose
The VA currently relies on manual, retrospective processes for payment integrity, leading to delayed detection and recoupment. PIVOT aims to modernize these capabilities through advanced analytics, automation, and integration with VA systems to enable systematic analysis of claims data, early detection of improper payments, and support cost containment.
Scope of Work
The VA requires a SaaS solution supporting a minimum of 100 concurrent users, integrating with existing VA systems and identity/access management (PIV authentication, role-based access). Key functionalities include:
- Data Ingest & Management: Process various claims formats (837P, 837I, 837D, NCPDP) and remittance advice (835), aggregate, normalize data, and maintain audit trails.
- Rules Engine: Execute VA and CMS compliance rules at scale, with configuration, version control, and audit logging.
- Pattern Recognition Engine: Utilize AI/ML to detect anomalies and suspicious billing behaviors, provide risk/confidence scoring, and explainable AI outputs.
- Workload Module: Centralized interface for VA staff to review flagged claims and manage dispositions.
- Dashboards & Reporting: Real-time dashboards, customizable reports, and export capabilities.
- Security & Compliance: FedRAMP High baseline, HIPAA, FISMA compliance, role-based access control, and audit logging.
Contract & Timeline
- Opportunity Type: Request for Information (RFI) - Market Research
- NAICS Code: DA10 (Support Services, Delivered As A Service Contract)
- Product Service Code: DA10
- Department/Agency: Veterans Affairs
- Vendor Intent to Participate Due: January 23, 2026, 12 PM ET
- Questions Due: January 23, 2026, 12 PM ET
- Technical Documents & Presentations Due: February 6, 2026, 12 PM ET
- Published Date: January 31, 2026
Evaluation & Submission
Vendors are invited to provide a Virtual Technical Demonstration (VTD) via Microsoft Teams (max 90 minutes), showcasing their solution's technical functionality, effectiveness, scalability, and security. Vendors must use representative data as the VA will not provide a dataset. Submissions must include a 2-page technical functionality description and a PowerPoint presentation. A Rough Order of Magnitude (ROM) for the full period of performance, including SaaS subscription and services, is also required. This RFI is for market research only; no costs incurred will be reimbursed.
Additional Notes
Set-aside decisions may be made based on RFI responses. The draft Performance Work Statement (PWS) 3.0, with major revisions in red font, is available for review. The PIVOT tool is for internal VA use, integrating with various VA data sources. While FedRAMP High authorization is required, solutions hosted on FedRAMP High authorized infrastructure committing to authorization during performance may be considered.